What is long-term care insurance?

Long-term care insurance (LTC or LTCI) helps cover the cost of long-term care in a skilled nursing facility, beyond a certain predetermined period and is meant to pay for care not covered by other insurance, Medicaid, or Medicare.

What can we expect Medicare to pay for a skilled nursing facility?

Medicare Part A (Hospital Insurance) provides time-limited coverage for skilled nursing care that is provided in a skilled nursing facility (SNF) when certain conditions are met. Learn more.

All of the following criteria must be met for the skilled care to be Medicare Part A eligible:

  • Patient must have Medicare Part A with days remaining in benefit period
  • There must have been an inpatient hospital stay of three consecutive days or more and the patient must enter the SNF soon after being released from the hospital.
  • A physician has prescribed care that requires the skills of RNs, LPNs, or speech/language, occupational or physical therapists.
  • The skilled care is needed daily on an inpatient basis.
  • The care is for the condition that
    • was treated during the previously discussed three-day hospitalization, or
    • began during care for another condition that received treatment during the qualifying 3-day stay

Daily rate for skilled nursing must include room and board:

  • Three daily meals plus snacks
  • Special diets if ordered by the doctor
  • Assistance with activities of daily living (bathing, personal hygiene, dressing, etc.)
  • Housekeeping daily
  • Linens for bed and bath
  • Administration of prescribed medications
  • Round-the-clock supervision by licensed nurses and nurse assistants
  • Feeding assistance